| Premise Health Of Wisconsin Medical, S.c. | |
|
2175 S Memorial Dr Appleton WI 54915-1414 | |
| (920) 202-5420 | |
| (920) 738-5580 |
| Full Name | Premise Health Of Wisconsin Medical, S.c. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2175 S Memorial Dr, Appleton, Wisconsin |
| Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) |
| Authorized Official Contact | 6154686270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Wisconsin Medical, S.c. 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | Premise Health Of Wisconsin Medical, S.c. 2175 S Memorial Dr Appleton WI 54915-1414 Ph: (920) 202-5420 |
| NPI Number | 1922791789 |
|---|---|
| Provider Enumeration Date | 05/30/2023 |
| Last Update Date | 05/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922791789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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